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PUBLIC HEALTH SERVItTS <br />SAN Ja,oU,N COUNTY <br />Facility Name <br />ENVIRONMENTAL HEALTH DIVISION <br />Ernest M. Fujimoto, M.D., M.P.H., Acting Health Officer <br />304 E.Weber Ave., 3rd Floor • P. O. Box 388 • Stockton, CA 95201-0388 <br />209/468-3420 <br />HAZARDOUS WASTE INSPECTION REPORT <br />/I 17 / <br />Address 12131a, <br />%/ - C�l�.2 � t�� S�G� C'• ��. <br />CityState CA Zip Code <br />EPA I.D.Number L DOO <br />Facility Contact P I L* Phone ��_ (�� f 7`f <br />Consent Given By <br />Inspection Date(s) C1 q Inspection Type (circle): Routin . Complaint Follow -Up <br />REPRESENTATIVES PRESENT <br />Name Title Organization <br />O o ' Yuv <br />This report may identify conditions observed this day that are alleged to be violations of one or more sections of the <br />California Health and Safety Code (HSC) or the California Code of Regulations, Title 22 (22 CCR) relating to the <br />management of hazardous waste. The violations may be described in more detail on the attached note sheets. After <br />completing the evaluation of the information obtained during the inspection, PHS-EHD may inform you of additional <br />violations. <br />If any violations are noted, the facility is required to submit a signed Certification of Return to Compliance within 60 <br />days, unless otherwise specified (A certification form is provided). <br />Failure to correct these violations within the scheduled period provided may result in San Joaquin County Public Health <br />Services -Environmental Health Division (PHS-EHD) citing you for continuing/additional violations. Issuance of this <br />Inspection Report does not preclude PHS-EHD from taking any administrative, cil or criminal action as a result of the <br />violations noted. --, ,, r <br />Rly-i <br />Registered Environmental Health Specialist <br />12/9/94 <br />A Division of San Joaquin County Health Care Services <br />Page 1 of L <br />